术前焦虑对腹腔镜非胃肠手术患者术后恶心呕吐的影响  

Effect of preoperative anxiety on postoperative nausea and vomiting in patients undergoing laparoscopic non-gastrointestinal surgery

作　　者：杜瑞妮 杨岚[1] 宋珂珂 刘冰玉 王鸽 高巍[1] DU Ruini;YANG Lan;SONG Keke;LIU Bingyu;WANG Ge;GAO Wei(Department of Anesthesiology,First Affiliated Hospital of Xi’an Jiaotong University,Xi’an,Shaanxi 710061,China)

机构地区：[1]西安交通大学第一附属医院麻醉科,西安710061

出　　处：《重庆医学》2023年第8期1137-1140,1146,共5页Chongqing medicine

基　　金：国家自然科学基金面上项目(81971290);陕西省重点研发计划项目(2020SF-136);中央高校基本科研业务费项目(xjj2018262)。

摘　　要：目的研究术前焦虑对腹腔镜非胃肠手术患者术后恶心呕吐(PONV)的影响。方法选取2019年9月1日至2020年9月30日在该院择期全身麻醉下行腹腔镜非胃肠手术患者632例作为研究对象,年龄18~50岁,体重指数为15~40 kg/m^(2),美国麻醉医师协会分级Ⅰ~Ⅲ级。术前采用医院焦虑抑郁量表对患者进行评估,≥9分者纳入焦虑组(n=320),<9分者纳入对照组(n=312)。记录术后24 h内2组PONV发生率、持续恶心发生率、恶心最高视觉模拟量表(VAS)评分、呕吐平均次数和呕吐最高VAS评分、术后疼痛评分、40项恢复质量评分量表(QoR-40)评分及术后住院时间。结果焦虑组PONV发生率、持续恶心发生率、呕吐发生率和呕吐平均次数均明显高于对照组,差异有统计学意义(P<0.05)。焦虑组术后恶心最高VAS评分、呕吐最高VAS评分、术后疼痛评分均明显高于对照组,差异有统计学意义(P<0.05)。焦虑组QoR-40各维度评分明显低于对照组,差异有统计学意义(P<0.05)。2组术后住院时间比较差异无统计学意义(P>0.05)。结论术前焦虑状态会增加腹腔镜非胃肠手术患者PONV发生率和严重程度,增加术后疼痛强度,降低患者术后早期恢复质量。Objective To investigate the effect of preoperative anxiety on postoperative nausea and vomiting in the patients undergoing laparoscopic non-gastrointestinal surgery.Methods A total of 632 patients aged 18-50 years old,BMI 15-40 kg/m^(2),ASA gradeⅠ-Ⅲ,scheduled for elective laparoscopic non-gastrointestinal surgery.The Hospital Anxiety and Depression Scale was adopted to evaluate the patients before operation.The patients with the score≥9 points were included in the preoperative anxiety group(n=320)and those with the score<9 points were included in the control group(n=312).The incidence rate of nausea and vomiting at postoperative 24 h,incidence rate of persistent nausea and the highest VAS score of nausea,average number of vomiting and highest VAS score of vomiting,postoperative pain score,score of 40-item recovered quality scale(QoR-40)and postoperative hospital stay duration were recorded.Results The incidence rates of PONV,persistent nausea and vomiting,and average vomiting times in the anxiety group were significantly higher than those in the control group(P<0.05).The highest VAS scores of postoperative nausea and vomiting and postoperative pain VAS score in the anxiety group were also significantly higher than those in the control group(P<0.05).The scores of QoR-40 various dimensions in the anxiety group were significantly lower than those in the control group(P<0.05).There was no statistically significant difference in the postoperative hospital stay duration between the two groups.Conclusion Preoperative anxiety status increases the incidence rate and severity degree of postoperative nausea and vomiting,increase postoperative pain intensity,and decrease the early quality of postoperative recovery.

关 键 词：焦虑 术后恶心呕吐 术后疼痛 术后恢复 非胃肠手术 

分 类 号：R245[医药卫生—针灸推拿学]